1
|
Contel IJ, Fonseca-Alves CE, Ferrari HF, Laufer-Amorim R, Xavier-Júnior JCC. Review of the comparative pathological and immunohistochemical features of human and canine cutaneous melanocytic neoplasms. J Comp Pathol 2024; 211:26-35. [PMID: 38761560 DOI: 10.1016/j.jcpa.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 02/10/2024] [Accepted: 04/14/2024] [Indexed: 05/20/2024]
Abstract
Melanocytic neoplasms originate from melanocytes and melanoma, the malignant form, is a common canine neoplasm and the most aggressive human skin cancer. Despite many similarities between these neoplasms in both species, only a limited number of studies have approached these entities in a comparative manner. Therefore, this review compares benign and malignant melanocytic neoplasms in dogs and humans, exclusively those arising in the haired skin, with regard to their clinicopathological, immunohistochemical and molecular aspects. Shared features include spontaneous occurrence, macroscopic features and microscopic findings when comparing human skin melanoma in the advanced/invasive stage and canine cutaneous melanoma, immunohistochemical markers and several histopathological prognostic factors. Differences include the apparent absence of active mutations in the BRAF gene in canine cutaneous melanoma and less aggressive clinical behaviour in dogs than in humans. Further studies are required to elucidate the aetiology and genetic development pathways of canine cutaneous melanocytic neoplasms. Evaluation of the applicability of histopathological prognostic parameters commonly used in humans for dogs are also needed. The similarities between the species and the recent findings regarding genetic mutations in canine cutaneous melanomas suggest the potential utility of dogs as a natural model for human melanomas that are not related to ultraviolet radiation.
Collapse
Affiliation(s)
- Isabeli J Contel
- Department of Pathology, Botucatu Medical School, São Paulo State University, Av. Prof. Mário R. Guimarães Montenegro, s/n, Campus Botucatu, 18618-687, Botucatu, SP, Brazil
| | - Carlos E Fonseca-Alves
- Institute of Health Sciences, Paulista University, Rua Luiz Levorato, 140, Jardim Marabá, 17048-290, Bauru, SP, Brazil
| | - Heitor F Ferrari
- University Center of Adamantina, Rua Nove de Julho, 730, Centro, 17800-057, Adamantina, SP, Brazil
| | - Renee Laufer-Amorim
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University, Rua Prof. Doutor Walter Mauricio Correa, s/n, Campus de Botucatu, 18618-681, Botucatu, SP, Brazil
| | - José C C Xavier-Júnior
- Department of Pathology, Botucatu Medical School, São Paulo State University, Av. Prof. Mário R. Guimarães Montenegro, s/n, Campus Botucatu, 18618-687, Botucatu, SP, Brazil; Salesian Catholic University Center Auxilium, Medical School, Rod. Sen. Teotônio Vilela, 3821, Jardim Alvorada, 16016-500, Araçatuba, SP, Brazil.
| |
Collapse
|
2
|
Yüceer RO, Başpınar Ş. Investigation of Ki67 and Phospho-Histone H3 Expressions in Urothelial Carcinoma of the Bladder by Immunohistochemical Method. Cureus 2024; 16:e55297. [PMID: 38558732 PMCID: PMC10981782 DOI: 10.7759/cureus.55297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND In our study, it is aimed to investigate the relationship between Ki67 and phospho-histone H3 (pHH3) expressions in bladder urothelial carcinomas, with clinicopathological parameters and survival, which have prognostic value. METHODS The study included 44 cases of high-grade urothelial carcinoma (HGUC), 37 cases of low-grade urothelial carcinoma (LGUC), and 11 nontumoral bladder cases. Ki67 and pHH3 were applied to the paraffin blocks of the tissues of 81 urothelial carcinoma and 11 nontumoral bladder cases by immunohistochemical method. Percentages of Ki67 and pHH3 expressions were evaluated by digital imaging analysis method. Expression percentages were compared with various clinicopathological parameters, and the relationship between them was evaluated. RESULTS Ki67 was expressed in 28% of urothelial carcinoma cases and 1% of nontumoral cases. pHH3 was expressed in 10.32% of urothelial carcinoma cases and 0.16% of nontumoral cases. In our study, we found significantly higher Ki67 and pHH3 expressions in urothelial carcinoma compared to nontumoral cases. There was a statistically significant relationship (p < 0.05) and a positive correlation between Ki67 expression and lymphovascular invasion, pT stage, and histological grade. A statistically significant relationship (p < 0.05) and a positive correlation were found between pHH3 expression and lymphovascular invasion, pT stage, recurrence, and histological grade. In addition, a statistically significant relationship was found between Ki67 and pHH3 expressions. In our study, survival was found to be low in high-grade urothelial carcinoma cases with lymphovascular invasion, advanced age (65 years and older), and high Ki67 and pHH3 expression rates. CONCLUSIONS According to our findings, high Ki67 and pHH3 expressions were found to be associated with poor prognostic parameters such as advanced pathologic stage, high histologic grade, and low survival. Our findings suggest that Ki67 and pHH3 may play a role in the differentiation, progression, and aggressive behavior of urothelial carcinoma. However, further studies are needed to confirm our findings and determine the role of these markers in urothelial carcinoma.
Collapse
Affiliation(s)
| | - Şirin Başpınar
- Medical Pathology, Süleyman Demirel University Faculty of Medicine, Isparta, TUR
| |
Collapse
|
3
|
Qi G, Liu J, Tao S, Fan W, Zheng H, Wang M, Yang H, Liu Y, Liu H, Zhou F. A retrospective study on expression and clinical significance of PHH3, Ki67 and P53 in bladder exophytic papillary urothelial neoplasms. PeerJ 2023; 11:e15675. [PMID: 37456895 PMCID: PMC10348311 DOI: 10.7717/peerj.15675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 06/11/2023] [Indexed: 07/18/2023] Open
Abstract
Background Exophytic papillary urothelial neoplasms (EPUN) are difficult to diagnose pathologically and are well-known for their heterogeneous prognoses. Thus, searching for an objective and accurate diagnostic marker is of great clinical value in improving the outcomes of EPUN patients. PHH3 was reported to be expressed explicitly in the mitotic phase of the cell cycle, and recent studies have shown that PHH3 expression was associated with the differential diagnosis and prognosis of many tumors. However, its significance in EPUN remains unclear. This study aimed to determine the expression of PHH3 in different EPUN, compare its expression with cell-cycle related proteins Ki67 and P53, and analyze its significance in the differential diagnosis and prognostic value for high-grade papillary urothelial carcinoma (HGPUC), low-grade papillary urothelial carcinoma (LGPUC), papillary urothelial neoplasm of low malignant potential (PUNLMP) and urothelial papilloma (UP). Methods We retrospectively analyzed the pathological diagnosis and clinical features of 26 HGPUC cases, 43 LGPUC cases, 21 PUNLMP cases and 11 UP cases. PHH3, Ki67 and P53 were detected by immunohistochemistry in 101 EPUN cases samples. The cut-off values of PHH3 mitosis count (PHMC), HE mitosis count (HEMC), Ki67 and P53 in the different EPUN were determined using the ROC curve. The distribution of counts in each group and its relationship with clinical parameters and prognosis of EPUN patients were also analyzed. Results The determination coefficient (R2 = 0.9980) of PHMC were more potent than those of HEMC (R2 = 0.9734) in the EPUN mitotic counts microscopically by both pathologists. Of the 101 EPUN cases investigated, significant positive linear correlations were found between PHMC and HEMC, PHMC and Ki67, and HEMC and Ki67 (P < 0.0001). In HGPUC, LGPUC, PUNLMP and UP, a decreasing trend was observed in the median and range of PHMC/10HPFs, HEMC/10HPFs, Ki67 (%) and P53 (%). PHMC, HEMC, Ki67 and P53 were associated with different clinical parameters of EPUN. PHMC, HEMC, Ki67 and P53 were found to exhibit substantial diagnostic values among different EPUN and tumor recurrence. Based on the ROC curve, when PHMC was >48.5/10HPFs, a diagnosis of HGPUC was more likely, and when PHMC was >13.5/10HPFs, LGPUC was more likely. In addition, when PHMC was >5.5/10HPFs, the possibility of non-infiltrating LGPUC was greater. Kaplan-Meier survival curve analysis showed that the median recurrence-free survival (RFS) for cases with PHMC > 13.5/10HPFs and HEMC > 14.5/10HPFs were 52.5 and 48 months, respectively, and their respective hazard ratio was significantly higher (Log-rank P < 0.05). Conclusion PHH3 exhibited high specificity and sensitivity in diagnosing EPUN. Combined with HEMC, Ki67 and P53, it can assist in the differential diagnosis of EPUN and estimate its clinical progression with high predictive value to a certain extent.
Collapse
Affiliation(s)
- Gaoxiu Qi
- Clinical Medical College, Weifang Medical University, Weifang, Shandong, China
| | - Jinmeng Liu
- Laboratory of Biochemistry and Molecular Biology, Weifang Medical University, Weifang, Shandong, China
| | - Shuqi Tao
- Department of Clinical Pathology, Weifang Medical University, Weifang, Shandong, China
| | - Wenyuan Fan
- Department of Clinical Pathology, Weifang Medical University, Weifang, Shandong, China
| | - Haoning Zheng
- Department of Clinical Pathology, Weifang Medical University, Weifang, Shandong, China
| | - Meihong Wang
- Department of Pathology, Hospital of PLA 80th group army, Weifang, Shandong, China
| | - Hanchao Yang
- Department of Pathology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, China
| | - Yongting Liu
- Department of forensic medicine, Qingzhou City Public Security Bureau Interpol Brigade, Weifang, Shandong, China
| | - Huancai Liu
- Affiliated Hospital of Weifang Medical University, Department of joint surgery, Weifang, Shandong, China
| | - Fenghua Zhou
- Department of Clinical Pathology, Weifang Medical University, Weifang, Shandong, China
| |
Collapse
|
4
|
Ibrahim A, Toss MS, Makhlouf S, Miligy IM, Minhas F, Rakha EA. Improving mitotic cell counting accuracy and efficiency using phosphohistone-H3 (PHH3) antibody counterstained with haematoxylin and eosin as part of breast cancer grading. Histopathology 2023; 82:393-406. [PMID: 36349500 PMCID: PMC10100421 DOI: 10.1111/his.14837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/08/2022] [Accepted: 11/05/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Mitotic count in breast cancer is an important prognostic marker. Unfortunately, substantial inter- and intraobserver variation exists when pathologists manually count mitotic figures. To alleviate this problem, we developed a new technique incorporating both haematoxylin and eosin (H&E) and phosphorylated histone H3 (PHH3), a marker highly specific to mitotic figures, and compared it to visual scoring of mitotic figures using H&E only. METHODS Two full-face sections from 97 cases were cut, one stained with H&E only, and the other was stained with PHH3 and counterstained with H&E (PHH3-H&E). Counting mitoses using PHH3-H&E was compared to traditional mitoses scoring using H&E in terms of reproducibility, scoring time, and the ability to detect mitosis hotspots. We assessed the agreement between manual and image analysis-assisted scoring of mitotic figures using H&E and PHH3-H&E-stained cells. The diagnostic performance of PHH3 in detecting mitotic figures in terms of sensitivity and specificity was measured. Finally, PHH3 replaced the mitosis score in a multivariate analysis to assess its significance. RESULTS Pathologists detected significantly higher mitotic figures using the PHH3-H&E (median ± SD, 20 ± 33) compared with H&E alone (median ± SD, 16 ± 25), P < 0.001. The concordance between pathologists in identifying mitotic figures was highest when using the dual PHH3-H&E technique; in addition, it highlighted mitotic figures at low power, allowing better agreement on choosing the hotspot area (k = 0.842) in comparison with standard H&E (k = 0.625). A better agreement between image analysis-assisted software and the human eye was observed for PHH3-stained mitotic figures. When the mitosis score was replaced with PHH3 in a Cox regression model with other grade components, PHH3 was an independent predictor of survival (hazard ratio [HR] 5.66, 95% confidence interval [CI] 1.92-16.69; P = 0.002), and even showed a more significant association with breast cancer-specific survival (BCSS) than mitosis (HR 3.63, 95% CI 1.49-8.86; P = 0.005) and Ki67 (P = 0.27). CONCLUSION Using PHH3-H&E-stained slides can reliably be used in routine scoring of mitotic figures and integrating both techniques will compensate for each other's limitations and improve diagnostic accuracy, quality, and precision.
Collapse
Affiliation(s)
- Asmaa Ibrahim
- Academic Unit for Translational Medical Sciences, School of Medicine, University of Nottingham Biodiscovery Institute, University Park, Nottingham, UK.,Histopathology department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Michael S Toss
- Academic Unit for Translational Medical Sciences, School of Medicine, University of Nottingham Biodiscovery Institute, University Park, Nottingham, UK
| | - Shorouk Makhlouf
- Academic Unit for Translational Medical Sciences, School of Medicine, University of Nottingham Biodiscovery Institute, University Park, Nottingham, UK.,Department of Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Islam M Miligy
- Histopathology department, Faculty of Medicine, Menoufia University, Shebin El Kom, Egypt.,Histopathology department, School of Medicine, University of Nottingham, Nottingham, UK
| | - Fayyaz Minhas
- Department of Computer Science, University of Warwick, Coventry, UK
| | - Emad A Rakha
- Academic Unit for Translational Medical Sciences, School of Medicine, University of Nottingham Biodiscovery Institute, University Park, Nottingham, UK.,Histopathology department, Faculty of Medicine, Menoufia University, Shebin El Kom, Egypt.,Histopathology department, School of Medicine, University of Nottingham, Nottingham, UK
| |
Collapse
|
5
|
Cheng TW, Ahern MC, Giubellino A. The Spectrum of Spitz Melanocytic Lesions: From Morphologic Diagnosis to Molecular Classification. Front Oncol 2022; 12:889223. [PMID: 35747831 PMCID: PMC9209745 DOI: 10.3389/fonc.2022.889223] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/26/2022] [Indexed: 11/17/2022] Open
Abstract
Spitz tumors represent a distinct subtype of melanocytic lesions with characteristic histopathologic features, some of which are overlapping with melanoma. More common in the pediatric and younger population, they can be clinically suspected by recognizing specific patterns on dermatoscopic examination, and several subtypes have been described. We now classify these lesions into benign Spitz nevi, intermediate lesions identified as “atypical Spitz tumors” (or Spitz melanocytoma) and malignant Spitz melanoma. More recently a large body of work has uncovered the molecular underpinning of Spitz tumors, including mutations in the HRAS gene and several gene fusions involving several protein kinases. Here we present an overarching view of our current knowledge and understanding of Spitz tumors, detailing clinical, histopathological and molecular features characteristic of these lesions.
Collapse
Affiliation(s)
- Tiffany W. Cheng
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, United States
| | - Madeline C. Ahern
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, United States
| | - Alessio Giubellino
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, United States
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States
- *Correspondence: Alessio Giubellino,
| |
Collapse
|
6
|
Omori R, Miyagaki T, Miyano K, Hashimoto Y, Kadono T. Multiple pigmented nevi induced by the combination of encorafenib and cetuximab in a colon cancer patient. J Dermatol 2022; 49:e264-e265. [PMID: 35403284 DOI: 10.1111/1346-8138.16393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 03/23/2022] [Accepted: 03/28/2022] [Indexed: 01/07/2023]
Affiliation(s)
- Reina Omori
- Department of Dermatology, Kawasaki Municipal Tama Hospital, Kawasaki, Japan.,Department of Dermatology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Tomomitsu Miyagaki
- Department of Dermatology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Kaoru Miyano
- Department of Dermatology, Kawasaki Municipal Tama Hospital, Kawasaki, Japan
| | - Yuki Hashimoto
- Department of Dermatology, Kawasaki Municipal Tama Hospital, Kawasaki, Japan
| | - Takafumi Kadono
- Department of Dermatology, St. Marianna University School of Medicine, Kawasaki, Japan
| |
Collapse
|
7
|
Sturm B, Creytens D, Smits J, Ooms AHAG, Eijken E, Kurpershoek E, Küsters-Vandevelde HVN, Wauters C, Blokx WAM, van der Laak JAWM. Computer-Aided Assessment of Melanocytic Lesions by Means of a Mitosis Algorithm. Diagnostics (Basel) 2022; 12:diagnostics12020436. [PMID: 35204526 PMCID: PMC8871065 DOI: 10.3390/diagnostics12020436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/31/2021] [Accepted: 01/14/2022] [Indexed: 11/16/2022] Open
Abstract
An increasing number of pathology laboratories are now fully digitised, using whole slide imaging (WSI) for routine diagnostics. WSI paves the road to use artificial intelligence (AI) that will play an increasing role in computer-aided diagnosis (CAD). In melanocytic skin lesions, the presence of a dermal mitosis may be an important clue for an intermediate or a malignant lesion and may indicate worse prognosis. In this study a mitosis algorithm primarily developed for breast carcinoma is applied to melanocytic skin lesions. This study aimed to assess whether the algorithm could be used in diagnosing melanocytic lesions, and to study the added value in diagnosing melanocytic lesions in a practical setting. WSI’s of a set of hematoxylin and eosin (H&E) stained slides of 99 melanocytic lesions (35 nevi, 4 intermediate melanocytic lesions, and 60 malignant melanomas, including 10 nevoid melanomas), for which a consensus diagnosis was reached by three academic pathologists, were subjected to a mitosis algorithm based on AI. Two academic and six general pathologists specialized in dermatopathology examined the WSI cases two times, first without mitosis annotations and after a washout period of at least 2 months with mitosis annotations based on the algorithm. The algorithm indicated true mitosis in lesional cells, i.e., melanocytes, and non-lesional cells, i.e., mainly keratinocytes and inflammatory cells. A high number of false positive mitosis was indicated as well, comprising melanin pigment, sebaceous glands nuclei, and spindle cell nuclei such as stromal cells and neuroid differentiated melanocytes. All but one pathologist reported more often a dermal mitosis with the mitosis algorithm, which on a regular basis, was incorrectly attributed to mitoses from mainly inflammatory cells. The overall concordance of the pathologists with the consensus diagnosis for all cases excluding nevoid melanoma (n = 89) appeared to be comparable with and without the use of AI (89% vs. 90%). However, the concordance increased by using AI in nevoid melanoma cases (n = 10) (75% vs. 68%). This study showed that in general cases, pathologists perform similarly with the aid of a mitosis algorithm developed primarily for breast cancer. In nevoid melanoma cases, pathologists perform better with the algorithm. From this study, it can be learned that pathologists need to be aware of potential pitfalls using CAD on H&E slides, e.g., misinterpreting dermal mitoses in non-melanotic cells.
Collapse
Affiliation(s)
- Bart Sturm
- Department of Pathology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands;
- Pathan B.V., 3045 PM Rotterdam, The Netherlands; (J.S.); (A.H.A.G.O.); (E.K.)
| | - David Creytens
- Department of Pathology, Ghent University Hospital, 9000 Ghent, Belgium;
| | - Jan Smits
- Pathan B.V., 3045 PM Rotterdam, The Netherlands; (J.S.); (A.H.A.G.O.); (E.K.)
| | | | - Erik Eijken
- Laboratory for Pathology Oost Nederland (LabPON), 7550 AM Hengelo, The Netherlands;
| | - Eline Kurpershoek
- Pathan B.V., 3045 PM Rotterdam, The Netherlands; (J.S.); (A.H.A.G.O.); (E.K.)
| | | | - Carla Wauters
- Department of Pathology, Canisius Wilhelmina Hospital, 6500 GS Nijmegen, The Netherlands; (H.V.N.K.-V.); (C.W.)
| | - Willeke A. M. Blokx
- Division Laboratories, Pharmacy and Biomedical Genetics, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands;
| | - Jeroen A. W. M. van der Laak
- Department of Pathology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands;
- Center for Medical Image Science and Visualization, Linköping University, 581 83 Linköping, Sweden
- Correspondence: ; Tel.: +31-638-814-869
| |
Collapse
|
8
|
Mirzaiian E, Tabatabaei Ghods ZS, Tavangar SM, Emami B, Oraie M, Safyari R, Saffar H. Utility of PHH3 in Evaluation of Mitotic Index in Breast Carcinoma and Impact on Tumor Grade. Asian Pac J Cancer Prev 2020; 21:63-66. [PMID: 31983165 PMCID: PMC7294007 DOI: 10.31557/apjcp.2020.21.1.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Indexed: 11/25/2022] Open
Abstract
Background: Mitotic activity index is considered as the most important grading component to predict prognosis in invasive breast carcinoma. But it is believed that it is also the cause of discordance in grade estimation based on Bloom-Richardson system. Thus, reproducible methods such as immunohistochemistry (IHC) based analysis methods appears to be of great value in facilitating mitotic count. Materials and Methods: In the present study, we examined the utility of Phosphohistone H3 by IHC in various grades of breast carcinoma and compared it with traditional mitotic count by hematoxylin and eosin (H and E) staining and probable changes in tumor grading. Results: Total 90 cases of invasive breast carcinoma were evaluated. Mean mitotic count were 8.6 and 6.4/10HPF in IHC and HandE groups, respectively. Although , mean average count was higher by IHC method , good correlation was observed(R=0.914). Using PHH3 IHC, two out of 33 cases of grade I tumors were upgraded in to grade II and three cases of grade II were upgraded in to grade III. None of the tumors were down graded. Conclusion: Similar to some other previous studies, we found PHH3 a robust sensitive and practical marker for mitotic count in breast carcinoma. Especially it is helpful to identify the most proliferating area. However, further studies are required to confirm the superiority of this biomarker for including in grading system.
Collapse
Affiliation(s)
- Elham Mirzaiian
- Department of Pathology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Seyed Mohammad Tavangar
- Department of Pathology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Binesh Emami
- Anatomical and Clinical Pathologist, Farvardin Laboratory, Tehran, Iran
| | | | - Roya Safyari
- Department of Pathology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hiva Saffar
- Department of Pathology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
9
|
Wu M, Yu Q, Gao B, Sheng L, Li Q, Xie F. A large-scale collection of giant congenital melanocytic nevi: Clinical and histopathological characteristics. Exp Ther Med 2019; 19:313-318. [PMID: 31853305 DOI: 10.3892/etm.2019.8198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 01/03/2018] [Indexed: 11/06/2022] Open
Abstract
Giant congenital melanocytic nevi (GCMN) place a heavy psychological burden on patients due to their poor cosmetic appearance. The histopathological characteristics of GCMN have remained largely elusive. The present study investigated the histopathological characteristics of GCMN in association with their clinical appearance. A total of 98 patients diagnosed with GCMN were included in the present study and their clinical features were collected from their records. Lesion specimens were obtained and stained for histopathological analysis. Regarding the microscopic appearance of GCMN, nevi cells in the whole dermis exhibited different patterns than those in healthy tissues. Most GCMN cases featured a sub-epidermal non-involvement zone, which implies an early occurrence in embryo development. Darker nevi exhibited a higher density of infiltrated nevi cells and more pigment deposition; this appears to induce a poor skin texture. Chemical peeling and laser therapy only partly removes pigment particles and nevi cells in the upper portion of the dermis. The clinical features of GCMN are associated with the histopathological characteristics, and non-surgical therapy cannot remove the nevus cells in the deep dermis.
Collapse
Affiliation(s)
- Min Wu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200011, P.R. China
| | - Qingxiong Yu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200011, P.R. China
| | - Bowen Gao
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200011, P.R. China
| | - Lingling Sheng
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200011, P.R. China
| | - Qingfeng Li
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200011, P.R. China
| | - Feng Xie
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200011, P.R. China
| |
Collapse
|
10
|
Davis LE, Shalin SC, Tackett AJ. Current state of melanoma diagnosis and treatment. Cancer Biol Ther 2019; 20:1366-1379. [PMID: 31366280 PMCID: PMC6804807 DOI: 10.1080/15384047.2019.1640032] [Citation(s) in RCA: 421] [Impact Index Per Article: 84.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 05/23/2019] [Accepted: 06/23/2019] [Indexed: 12/13/2022] Open
Abstract
Melanoma is the deadliest form of skin cancer. In the early stages, melanoma can be treated successfully with surgery alone and survival rates are high, but after metastasis survival rates drop significantly. Therefore, early and correct diagnosis is key for ensuring patients have the best possible prognosis. Melanoma misdiagnosis accounts for more pathology and dermatology malpractice claims than any cancer other than breast cancer, as an early misdiagnosis can significantly reduce a patient's chances of survival. As far as treatment for metastatic melanoma goes, there have been several new drugs developed over the last 10 years that have greatly improved the prognosis of patients with metastatic melanoma, however, a majority of patients do not show a lasting response to these treatments. Thus, new biomarkers and drug targets are needed to improve the accuracy of melanoma diagnosis and treatment. This article will discuss the major advancements of melanoma diagnosis and treatment from antiquity to the present day.
Collapse
Affiliation(s)
- Lauren E. Davis
- University of Arkansas for Medical Sciences, Department of Biochemistry and Molecular Biology, Little Rock, AR, USA
| | - Sara C. Shalin
- University of Arkansas for Medical Sciences, Department of Pathology, Little Rock, AR, USA
| | - Alan J. Tackett
- University of Arkansas for Medical Sciences, Department of Biochemistry and Molecular Biology, Little Rock, AR, USA
| |
Collapse
|
11
|
Observational Study Examining the Diagnostic Practice of Ki67 Staining for Melanocytic Lesions. Am J Dermatopathol 2019; 41:488-491. [DOI: 10.1097/dad.0000000000001379] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
12
|
Mancera N, Smalley KSM, Margo CE. Melanoma of the eyelid and periocular skin: Histopathologic classification and molecular pathology. Surv Ophthalmol 2019; 64:272-288. [PMID: 30578807 DOI: 10.1016/j.survophthal.2018.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 12/12/2018] [Accepted: 12/12/2018] [Indexed: 12/29/2022]
Abstract
Cutaneous melanoma, a potentially lethal malignancy of the periocular skin, represents only a small proportion of the roughly 87,000 new cases of cutaneous melanoma diagnosed annually in the United States. Most of our understanding of melanoma of the eyelid skin is extrapolated from studies of cutaneous melanoma located elsewhere. Recent years have witnessed major breakthroughs in molecular biology and genomics of cutaneous melanoma, some of which have led to the development of targeted therapies. The molecular insights have also kindled interest in rethinking how cutaneous melanomas are classified and assessed for risk. We provide a synopsis of the epidemiology, histopathologic classification, and clinical experience of eyelid melanoma since 1990 and then review major advances in the molecular biology of cutaneous melanoma, exploring how this impacts our understanding of classification and predicting risk.
Collapse
Affiliation(s)
- Norberto Mancera
- Department of Ophthalmology, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
| | - Keiran S M Smalley
- Departments of Tumor Biology, The Moffitt Cancer Center & Research Institute, Tampa, Florida, USA; Cutaneous Oncology The Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Curtis E Margo
- Department of Ophthalmology, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA; Department of Pathology and Cell Biology, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| |
Collapse
|
13
|
Phosphohistone H3 (PHH3) as a surrogate of mitotic figure count for grading in meningiomas: a comparison of PHH3 (S10) versus PHH3 (S28) antibodies. Virchows Arch 2018; 474:87-96. [DOI: 10.1007/s00428-018-2458-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 08/14/2018] [Accepted: 09/17/2018] [Indexed: 02/01/2023]
|
14
|
Melanocytic nevi and melanoma: unraveling a complex relationship. Oncogene 2017; 36:5771-5792. [PMID: 28604751 DOI: 10.1038/onc.2017.189] [Citation(s) in RCA: 120] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 05/09/2017] [Accepted: 05/10/2017] [Indexed: 12/11/2022]
Abstract
Approximately 33% of melanomas are derived directly from benign, melanocytic nevi. Despite this, the vast majority of melanocytic nevi, which typically form as a result of BRAFV600E-activating mutations, will never progress to melanoma. Herein, we synthesize basic scientific insights and data from mouse models with common observations from clinical practice to comprehensively review melanocytic nevus biology. In particular, we focus on the mechanisms by which growth arrest is established after BRAFV600E mutation. Means by which growth arrest can be overcome and how melanocytic nevi relate to melanoma are also considered. Finally, we present a new conceptual paradigm for understanding the growth arrest of melanocytic nevi in vivo termed stable clonal expansion. This review builds upon the canonical hypothesis of oncogene-induced senescence in growth arrest and tumor suppression in melanocytic nevi and melanoma.
Collapse
|
15
|
Tracht J, Zhang K, Peker D. Grading and Prognostication of Neuroendocrine Tumors of the Pancreas: A Comparison Study of Ki67 and PHH3. J Histochem Cytochem 2017. [PMID: 28651471 DOI: 10.1369/0022155417708186] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Grading of pancreatic neuroendocrine tumors (pNETs) is currently based on mitotic rate and Ki67 proliferation index. Phosphohistone-H3 (PHH3) is an effective marker for mitosis that has been proposed to use in grading various NETs. It remains unclear which method more accurately predicts grade and clinical outcome. Cases of pNET were evaluated using immunohistochemical stains for Ki67 and PHH3. In addition, each case was evaluated for necrosis, lymphovascular invasion, and perineural invasion and compared with stage. R project statistical analysis was used for comparisons. Sixty-three cases were included in the study including 29 males and 34 females (M:F 0.9) with a median age of 59 years (ranging 34-84). There was not a significant discrepancy in the stratification of tumor grades for Ki67 and PHH3. PHH3 significantly predicted lymph node metastasis ( p=0.041). Necrosis correlated with overall survival ( p=0.017). The results suggest that PHH3 is an effective marker for determining mitotic activity and can be used alternative to Ki67. In addition, necrosis may be included in the reporting of pNET as it may play a prognostic role. Larger scale studies are warranted to understand the biology and behavior of these tumors.
Collapse
Affiliation(s)
- Jessica Tracht
- Department of Pathology, The University of Alabama at Birmingham School of Medicine, Birmingham, Alabama (JT, DP)
| | - Kui Zhang
- Department of Biostatistics, The University of Alabama at Birmingham School of Public Health, Birmingham, Alabama (KZ)
| | - Deniz Peker
- Department of Pathology, The University of Alabama at Birmingham School of Medicine, Birmingham, Alabama (JT, DP)
| |
Collapse
|
16
|
Kim JY, Jeong HS, Chung T, Kim M, Lee JH, Jung WH, Koo JS. The value of phosphohistone H3 as a proliferation marker for evaluating invasive breast cancers: A comparative study with Ki67. Oncotarget 2017; 8:65064-65076. [PMID: 29029412 PMCID: PMC5630312 DOI: 10.18632/oncotarget.17775] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 04/25/2017] [Indexed: 12/25/2022] Open
Abstract
Background Established measurements of proliferation in breast cancer are Ki67 and mitotic-activity-index (MAI), with problems in reproducibility and prognostic accuracy. Phosphohistone H3 (PHH3), a relatively novel IHC marker is specific for mitosis with good reproducibility. We hypothesized that PHH3 would be more reproducible and better represent proliferation than Ki67. Results PHH3 identified easily-missed mitosis by MAI, as demonstrated by upgrading M grade at diagnosis (n = 29/218, evenly distributed). PHH3 accurately found hot-spots, supported by mitotic count agreement between low-power and 10HPFs (R2 = 0.999; P = 0.001). PHH3 was more reproducible than Ki67, measured by five-rater inter-class correlation coefficient (0.904 > 0.712; P = 0.008). Finally, despite a relatively short follow-up (median 46 months; 7 recurrences) PHH3 was the only variable correlated with disease-free survival (P = 0.043), while all other conventional clinicopathologic variables, including Ki67 (P = 0.356), did not. Materials and Methods We compared Ki67 and PHH3 for 218 breast cancer surgical cases diagnosed from 2012 to 2013 at Severance hospital. The most representative invasive breast cancer surgical slides were immunohistochemically stained for Ki67 and PHH3. Conclusions Poor reproducibility and inadequate representation of proliferation of Ki67 and MAI may be improved by PHH3, allowing better accuracy in breast cancer diagnostics.
Collapse
Affiliation(s)
- Ji-Ye Kim
- Department of Pathology and Translational Genomics, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea.,Department of Pathology, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea
| | - Hyang Sook Jeong
- Department of Pathology, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea
| | - Taek Chung
- Department of Pathology, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea
| | - Moonsik Kim
- Department of Pathology, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea
| | - Ji Hee Lee
- Department of Pathology, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea
| | - Woo Hee Jung
- Department of Pathology, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea
| | - Ja Seung Koo
- Department of Pathology, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea
| |
Collapse
|
17
|
Use of New Techniques in Addition to IHC Applied to the Diagnosis of Melanocytic Lesions, With Emphasis on CGH, FISH, and Mass Spectrometry. ACTAS DERMO-SIFILIOGRAFICAS 2017; 108:17-30. [DOI: 10.1016/j.ad.2016.05.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 05/03/2016] [Accepted: 05/09/2016] [Indexed: 02/08/2023] Open
|
18
|
Nagarajan P, Tetzlaff M, Curry J, Prieto V. Use of New Techniques in Addition to IHC Applied to the Diagnosis of Melanocytic Lesions, With Emphasis on CGH, FISH, and Mass Spectrometry. ACTAS DERMO-SIFILIOGRAFICAS 2017. [DOI: 10.1016/j.adengl.2016.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
19
|
Hartmann D, Ruini C, Mathemeier L, Bachmann MR, Dietrich A, Ruzicka T, von Braunmühl T. Identification of ex-vivo confocal laser scanning microscopic features of melanocytic lesions and their histological correlates. JOURNAL OF BIOPHOTONICS 2017; 10:128-142. [PMID: 27091702 DOI: 10.1002/jbio.201500335] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 04/04/2016] [Accepted: 04/05/2016] [Indexed: 06/05/2023]
Abstract
Ex-vivo confocal laser scanning microscopy (CLSM) offers rapid tissue examination. Current literature shows promising results in the evaluation of non-melanoma skin cancer but little is known about presentation of melanocytic lesions (ML). This study evaluates ML with ex-vivo CLSM in comparison to histology and offers an overview of ex-vivo CLSM characteristics. 31 ML were stained with acridine orange or fluorescein and examined using ex-vivo CLSM (Vivascope2500® ; Lucid Inc; Rochester NY) in reflectance and fluorescence mode. Confocal images were correlated to histopathology. Benign and malignant features of the ML were listed and results were presented. Sensitivity and specificity were calculated using contingency tables. The ML included junctional, compound, dermal, Spitz and dysplastic nevi, as well as various melanoma subtypes. The correlation of the confocal findings with histopathology allowed the identification of different types of ML and differentiation of benign and malignant features. The study offers an overview of confocal characteristics of ML in comparison to histology. Ex-vivo CLSM does not reproduce the typical in-vivo horizontal mosaics but rather reflects the vertical histological presentation. Not all typical in-vivo patterns are detectable here. These findings may help to evaluate the ex-vivo CLSM as an adjunctive tool in the immediate intraoperative diagnosis of ML. Superficial spreading malignant melanoma. Histopathology (H&E stain; 200×) correlated to the reflectance (RM; 830 nm) and fluorescence mode (FM; 488 nm) in the ex-vivo CLSM (Vivablock® by VivaScan® , acridine orange).
Collapse
Affiliation(s)
- Daniela Hartmann
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Frauenlobstr. 9-11, 80337, Munich, Germany
- Department of Dermatology, Municipal Hospital of Munich, Thalkirchner Str. 48, 80337, Munich, Germany
| | - Cristel Ruini
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Frauenlobstr. 9-11, 80337, Munich, Germany
- Department of Dermatology, Municipal Hospital of Munich, Thalkirchner Str. 48, 80337, Munich, Germany
| | - Leonie Mathemeier
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - Mario Raphael Bachmann
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - Andreas Dietrich
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - Thomas Ruzicka
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Frauenlobstr. 9-11, 80337, Munich, Germany
- Department of Dermatology, Municipal Hospital of Munich, Thalkirchner Str. 48, 80337, Munich, Germany
| | - Tanja von Braunmühl
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Frauenlobstr. 9-11, 80337, Munich, Germany
- Department of Dermatology, Municipal Hospital of Munich, Thalkirchner Str. 48, 80337, Munich, Germany
| |
Collapse
|
20
|
Wandler A, Spaun E, Steiniche T, Nielsen PS. Automated quantification of Ki67/MART1 stains may prevent false-negative melanoma diagnoses. J Cutan Pathol 2016; 43:956-962. [PMID: 27461337 DOI: 10.1111/cup.12778] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 07/07/2016] [Accepted: 07/22/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Inability to distinguish melanomas from benign nevi is the most frequent reason for malpractice lawsuits in surgical pathology. Reliable diagnostic tools to support hematoxylin and eosin (H&E) stains and induce diagnostic vigilance are thus highly needed. Because high diagnostic performance recently was showed using automated image analysis, the immunohistochemical proliferation marker Ki67 seems a potential candidate. This study aimed to investigate if this previously presented automated algorithm could have prevented 10 false-negative melanoma diagnoses. In addition, diagnostic utility of another, but narrower, immunohistochemical proliferation marker, phosphohistone H3 (PHH3), was explored. METHODS A total of 10 formalin-fixed paraffin-embedded melanocytic tumors, initially classified as benign or dysplastic but revised as melanomas at metastatic debut, were dual-stained for Ki67/MART1 and PHH3/MART1. A Ki67 index was automatically calculated in epidermis, dermis, a combination of such, and a dermal hot spot. Dermal PHH3/MART1 scores were established semi-automatically. RESULTS The dermal Ki67 index identified all 10 melanomas, the hot-spot index 8 and the epidermal and combined indices only 2 and 5, respectively. Nine melanomas were PHH3 positive and scores correlated with Ki67. CONCLUSIONS PHH3 added limited information, but supplemental automated Ki67 assessment could possibly have prevented the misdiagnosis of most melanomas had the algorithm been available at the time of diagnosis.
Collapse
Affiliation(s)
- Anne Wandler
- Department of Pathology, Aarhus University Hospital, DK-8000, Aarhus C, Denmark
| | - Eva Spaun
- Department of Pathology, Aarhus University Hospital, DK-8000, Aarhus C, Denmark
| | - Torben Steiniche
- Department of Pathology, Aarhus University Hospital, DK-8000, Aarhus C, Denmark
| | - Patricia S Nielsen
- Department of Pathology, Aarhus University Hospital, DK-8000, Aarhus C, Denmark.
| |
Collapse
|
21
|
Winther TL, Arnli MB, Salvesen Ø, Torp SH. Phosphohistone-H3 Proliferation Index Is Superior to Mitotic Index and MIB-1 Expression as a Predictor of Recurrence in Human Meningiomas. Am J Clin Pathol 2016; 146:510-20. [PMID: 27686177 DOI: 10.1093/ajcp/aqw141] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES This study investigated the prognostic value of the phosphohistone-H3 (PHH3) proliferation index (PI) in human meningiomas and compared the reliability with the conventional mitotic index and MIB-1 biomarker. METHODS Proliferative activity was determined in 160 patients by standardized immunohistochemistry on tissue microarrays and related to recurrence. RESULTS All three proliferation assessment methods were significantly associated with World Health Organization grade. The optimal cutoff values for recurrence prediction were 3% for the MIB-1 PI and 0.5% for the PHH3 PI. Increased PHH3 PI was significantly associated with recurrence-free survival in univariate Cox proportional hazards regression analysis (P = .011) and remained an independent predictor in multivariate analysis (P = .005). Mitotic index and MIB-1 PI did not reach statistical significance. CONCLUSIONS PHH3 immunostaining allowed for the easiest, fastest, and most objective assessment of proliferation and proved to be the most accurate and reliable method for predicting recurrence in patients resected for meningiomas.
Collapse
Affiliation(s)
- Theo L Winther
- From the Departments of Laboratory Medicine, Children's and Women's Health,
| | - Magnus B Arnli
- From the Departments of Laboratory Medicine, Children's and Women's Health
| | | | - Sverre H Torp
- From the Departments of Laboratory Medicine, Children's and Women's Health, Pathology and Medical Genetics, St Olavs Hospital, Trondheim, Norway
| |
Collapse
|
22
|
Abstract
Survivin, a member of the inhibitor of apoptosis (IAP) protein family that inhibits caspases and blocks cell death, is highly expressed in most cancers and is associated with a poor clinical outcome. Survivin has consistently been identified by molecular profiling analysis to be associated with high tumour grade cancers, different disease survival and recurrence. Polymorphisms in the survivin gene are emerging as powerful tools to study the biology of the disease and have the potential to be used in disease prognosis and diagnosis. The survivin gene polymorphisms have also been reported to influence tumour aggressiveness as well as survival of cancer patients. The differential expression of survivin in cancer cells compared to normal tissues and its role as a nodal protein in a number of cellular pathways make it a high target for different therapeutics. This review discusses the complex circuitry of survivin in human cancers and gene variants of survivin, and highlights novel therapy that targets this important protein.
Collapse
Affiliation(s)
| | | | - R D Mittal
- Department of Urology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| |
Collapse
|
23
|
Villani V, Mahadevan KK, Ligorio M, Fernández-Del Castillo C, Ting DT, Sabbatino F, Zhang I, Vangel M, Ferrone S, Warshaw AL, Lillemoe KD, Wargo J, Deshpande V, Ferrone CR. Phosphorylated Histone H3 (PHH3) Is a Superior Proliferation Marker for Prognosis of Pancreatic Neuroendocrine Tumors. Ann Surg Oncol 2016; 23:609-617. [PMID: 27020585 DOI: 10.1245/s10434-016-5171-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND The staging of pancreatic neuroendocrine tumors (PNETs) is continuously evolving. Mitotic count, as measured by hematoxylin and eosin (H&E) or Ki67 labeling index (Ki67LI), is the best predictor of disease biology. However, both of these methods have several limitations. Phosphorylated histone H3 (PHH3), a novel mitotic marker, is potentially more accurate and easier to evaluate. This study aimed to evaluate the prognostic impact of PHH3 on patients with PNETs. METHODS Clinicopathologic data and paraffin-embedded tissue were evaluated for 100 of the 247 PNET patients whose tumors were resected between 1998 and 2010. Mitotic counts were analyzed on H&E-, Ki67-, and PHH3-stained slides by two independent pathologists. Kaplan-Meier curves, log-rank tests, Cox regression models, and time-dependent receiver operative characteristics (ROC) curves were used to evaluate the prognostic power of these markers. An internal data cross-validation was performed to select the best cutoff. RESULTS Of the 100 PNET patients resected, 53 were men. The median age of the patients was 59 years (range 19-96 years). The median follow-up period was 68 months (range 3-186 months). The median time for evaluation of an H&E- or PHH3-stained slide was 3 min, relative to 15 min for Ki67. The findings showed H&E, Ki67, and PHH3 all to be excellent predictors of disease-specific survival (DSS). However, PHH3 was superior to H&E and Ki67 in predicting both disease-free survival (DFS) (p = 0.006) and DSS (p = 0.001). Evaluation of the PHH3 mitotic count showed 7 mitoses per 10 high-power fields (HPFs) to be the optimal cutoff for differentiating between low- and high-risk PNET patients. CONCLUSIONS PHH3 is a better predictor of both DFS and DSS than H&E or Ki67 in PNET. In addition, PHH3 appears to be both easier to interpret and more accurate when compared to current prognostic markers.
Collapse
Affiliation(s)
- Vincenzo Villani
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Krishnan K Mahadevan
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Matteo Ligorio
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - David T Ting
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Francesco Sabbatino
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Irene Zhang
- Doctor of Medicine Program, Harvard Medical School, Boston, MA, USA
| | - Mark Vangel
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Soldano Ferrone
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Andrew L Warshaw
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Keith D Lillemoe
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jennifer Wargo
- Department of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Vikram Deshpande
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Cristina R Ferrone
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
24
|
Lamba Saini M, Bouzin C, Weynand B, Marbaix E. An Appraisal of Proliferation and Apoptotic Markers in Papillary Thyroid Carcinoma: An Automated Analysis. PLoS One 2016; 11:e0148656. [PMID: 26863116 PMCID: PMC4749175 DOI: 10.1371/journal.pone.0148656] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 01/21/2016] [Indexed: 02/07/2023] Open
Abstract
Introduction Proliferation and apoptosis are opposing processes by which the cell numbers are kept in a delicate balance, essential for tissue homeostasis, whereas uncontrolled growth of cells is a hallmark of cancer. Papillary thyroid cancer (PTC) is the commonest type of thyroid cancer, with some PTC following an indolent course, whereas the other ones are more aggressive. Aim To evaluate respective contribution of proliferation and apoptosis in the tumorigenesis of PTC by automated analysis. Materials and Methods We investigated the immunolabeling of phosphorylated histone H3 (pHH3), cyclin D1, active caspase-3, and bcl-2 in thirteen cases each of metastatic PTC, follicular variant of PTC (FVPTC), papillary microcarcinoma (PMC) and well differentiated tumor of uncertain malignant potential (WDT-UMP). FVPTC cases comprised seven encapsulated and six unencapsulated cases. Results Proliferation, as assessed by pHH3 and cyclin D1 immunolabeling, was increased in all PTC variants, including the putative precursor lesion WDT-UMP, compared to normal thyroid tissue. pHH3 was immunolabeled in more cells of metastatic PTC than of PMC and of encapsulated FVPTC. Surprisingly, metastatic PTC and unencapsulated FVPTC also demonstrated more cleaved caspase-3 immunolabeled cells than the other types. In contrast, increased expression of bcl-2 protein was seen in normal thyroid areas, encapsulated FVPTC and PMC as compared to metastatic PTC. Metastatic PTC shows higher proliferation than other types of PTC but unexpectedly also higher apoptotic levels. Similar results were also seen with unencapsulated FVPTC, thus suggesting that unencapsulated FVPTC has a potential for adverse outcome. Bcl-2 was immunolabeled in a low percentage of cells in WDT-UMP. Conclusions The expression of the proliferative protein pHH3 together with the apoptotic marker cleaved caspase-3 may indicate an aggressive behaviour of PTC and loss of apoptosis inhibition by bcl-2 protein can further amplify the role of these proteins in tumor progression. Both cyclin D1 and bcl-2 could prove to be interesting markers of PTC precursor lesions. Automated/digital image quantification approach helps in refining the diagnostic accuracy.
Collapse
Affiliation(s)
- Monika Lamba Saini
- Service d'anatomie pathologique, Cliniques universitaires Saint-Luc, and Institut de Duve, Université catholique de Louvain, Avenue Hippocrate, 10 T-1, B-1200, Bruxelles, Belgium
- * E-mail: ;
| | - Caroline Bouzin
- IREC Imaging Platform (2IP), Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, Belgium
| | - Birgit Weynand
- Pathologische Ontleedkunde, Universitair Ziekenhuis Leuven, Herestraat, 49, B-3000, Leuven, Belgium
| | - Etienne Marbaix
- Service d'anatomie pathologique, Cliniques universitaires Saint-Luc, and Institut de Duve, Université catholique de Louvain, Avenue Hippocrate, 10 T-1, B-1200, Bruxelles, Belgium
| |
Collapse
|
25
|
Sreeraman Kumar R, Messina JL, Reed D, Navid F, Sondak VK. Pediatric Melanoma and Atypical Melanocytic Neoplasms. Cancer Treat Res 2016; 167:331-369. [PMID: 26601871 DOI: 10.1007/978-3-319-22539-5_15] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Melanoma is uncommon in the pediatric age range, but is increasing in frequency and often presents with atypical features compared to the classic ABCDE criteria common to adult melanoma cases. Moreover, many melanocytic neoplasms in childhood pose diagnostic challenges to the pathologist, and sometimes cannot be unequivocally classified as benign nevi or melanoma. This chapter addresses the evaluation and management of pediatric patients with melanoma and atypical melanocytic neoplasms, including the roles of and unresolved questions surrounding sentinel lymph node biopsy, completion lymphadenectomy, adjuvant therapy, and treatment of advanced disease.
Collapse
Affiliation(s)
| | - Jane L Messina
- Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, FL, USA
- Department of Cutaneous Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
- Department of Pathology and Cell Biology, University of South Florida Morsani College of Medicine, Tampa, FL, USA
- Department of Oncologic Sciences, University of South Florida Morsani College of Medicine, Tampa, FL, USA
- Department of Dermatology, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Damon Reed
- Department of Cutaneous Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
- Department of Oncologic Sciences, University of South Florida Morsani College of Medicine, Tampa, FL, USA
- Adolescent and Young Adult (AYA) Program, Sarcoma Department, Moffitt Cancer Center, Tampa, FL, USA
- Department of Hematology/Oncology , All Children's Hospital Johns Hopkins Medicine , St. Petersburg, FL, USA
| | - Fariba Navid
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Vernon K Sondak
- Department of Cutaneous Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA.
- Department of Oncologic Sciences and Surgery, University of South Florida Morsani College of Medicine, Tampa, FL, USA.
| |
Collapse
|
26
|
Lu D, Levin EC, Dehner LP, Lind AC. Proliferative activity in melanocytic nevi from patients grouped by age with clinical follow-up. J Cutan Pathol 2015; 42:959-964. [DOI: 10.1111/cup.12598] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Revised: 09/20/2011] [Accepted: 10/17/2011] [Indexed: 11/26/2022]
Affiliation(s)
- Dongsi Lu
- Lauren V. Ackerman Laboratory of Surgical Pathology, Department of Pathology and Immunology; Washington University School of Medicine; St. Louis MO USA
| | - Ethan C. Levin
- Washington University School of Medicine; St. Louis MO USA
| | - Louis P. Dehner
- Lauren V. Ackerman Laboratory of Surgical Pathology, Department of Pathology and Immunology; Washington University School of Medicine; St. Louis MO USA
| | - Anne C. Lind
- Lauren V. Ackerman Laboratory of Surgical Pathology, Department of Pathology and Immunology; Washington University School of Medicine; St. Louis MO USA
| |
Collapse
|
27
|
Uguen A, Talagas M, Costa S, Duigou S, Bouvier S, De Braekeleer M, Marcorelles P. A p16-Ki-67-HMB45 immunohistochemistry scoring system as an ancillary diagnostic tool in the diagnosis of melanoma. Diagn Pathol 2015; 10:195. [PMID: 26503349 PMCID: PMC4623282 DOI: 10.1186/s13000-015-0431-9] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 10/17/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Melanoma is a skin cancer which treatment requires early diagnosis and large surgical removal. The histopathological diagnosis of a melanocytic tumour is sometimes difficult between a benign nevus and a malignant melanoma. We built an immunomarker-based score to differentiate nevi from melanomas. METHODS Two independent sets of 308 (first set) and 62 (validation set) formalin-fixed and paraffin embedded tumour samples were studied using p16-Ki-67 and HMB45-MelanA dual-staining immunohistochemistry. RESULTS In the first set of tumours, high Ki-67 index, low to null p16 immunohistochemistry and absence of HMB45 immunohistochemistry gradient were more frequent in melanomas (156 primary tumours and 78 metastases) than in nevi (74 tumours). Nevertheless, none of these single parameters was able to differentiate all primary melanomas from all nevi. We built a scoring system based on the addition of semi-quantitative scorings of Ki-67 (0: <2%; 1:2-5%; 2:6-10%, 3:11-20%; 4:>20%) and p16 (0:>50% stained cells; 1:11-50%; 2:1-10%; 3:0%) and HMB45 staining (0: gradient present; 1: doubtful/inconclusive gradient; 2: gradient absent). A p16-Ki-67-HMB45 total score from 0 to 9 permitted to classify nevi (score <4) and primary melanomas (score ≥4) with a sensitivity of 97.4% and a specificity of 97.3% in the first set of tumours. Sensibility and specificity of 100 % were obtained in a second set (validation set) of 62 tumours (46 melanomas and 16 nevi). The total scoring also allowed analyzing 11 difficult or initially misdiagnosed tumours in our files. CONCLUSIONS We propose a valuable triple p16-Ki-67-HMB45 immunohistochemistry scoring system to help pathologists in the differential diagnosis of melanomas and nevi.
Collapse
Affiliation(s)
- Arnaud Uguen
- Inserm, U1078, Brest, F-29200, France.
- CHRU Brest, Service d'anatomie et cytologie pathologiques, Brest, F-29220, France.
- Université Européenne de Bretagne, Rennes, France.
- Department of Pathology, University Hospital Morvan, 5, Avenue Foch, 29609, Brest, France.
| | - Matthieu Talagas
- CHRU Brest, Service d'anatomie et cytologie pathologiques, Brest, F-29220, France.
- Université Européenne de Bretagne, Rennes, France.
- Department of Pathology, University Hospital Morvan, 5, Avenue Foch, 29609, Brest, France.
| | - Sebastian Costa
- CHRU Brest, Service d'anatomie et cytologie pathologiques, Brest, F-29220, France.
| | - Sandrine Duigou
- CHRU Brest, Service d'anatomie et cytologie pathologiques, Brest, F-29220, France.
| | - Stéphanie Bouvier
- CHRU Brest, Service d'anatomie et cytologie pathologiques, Brest, F-29220, France.
| | - Marc De Braekeleer
- Inserm, U1078, Brest, F-29200, France.
- Université Européenne de Bretagne, Rennes, France.
- CHRU Brest, Laboratoire de Cytogénétique et Biologie de la Reproduction, Brest, F-29220, France.
| | - Pascale Marcorelles
- CHRU Brest, Service d'anatomie et cytologie pathologiques, Brest, F-29220, France.
- Université Européenne de Bretagne, Rennes, France.
- Department of Pathology, University Hospital Morvan, 5, Avenue Foch, 29609, Brest, France.
| |
Collapse
|
28
|
Abstract
Cutaneous basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) represent 45.5% and 37.02%, respectively, of total malignant skin cancer according to the latest registry of Egyptian National Cancer Institute. Minichromosome maintenance (MCM) proteins are essential replication initiation factors. The current study examined the immunohistochemical expression of MCM2 in normal skin (10 cases), some proliferative skin lesions (6 psoriasis, 2 keratoacanthoma, and 2 seborrheic keratosis), and nonmelanoma epithelial skin cancers (20 BCC and 21 SCC). MCM2 was expressed in basal layer of normal epidermis and upregulated in proliferative skin lesions and nonmelanoma epithelial skin cancers without significant differences between the latter groups (P > 0.05). Mean and median values of MCM2 percentage of expression in BCC were higher than that of SCC (P = 0.004). MCM2 promotes proliferative capacity of the cells manifested by its expression in basal layer of epidermis, hyperproliferative skin lesions, and malignant cutaneous tumors. Proliferative capacity of BCC may be higher than SCC and this does not necessarily reflect aggressive behavior.
Collapse
|
29
|
Dreyling M, Ferrero S, Vogt N, Klapper W. New paradigms in mantle cell lymphoma: is it time to risk-stratify treatment based on the proliferative signature? Clin Cancer Res 2015; 20:5194-206. [PMID: 25320369 DOI: 10.1158/1078-0432.ccr-14-0836] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The elucidation of crucial biologic pathways of cell survival and proliferation has led to the development of highly effective drugs, some of which have markedly improved mantle cell lymphoma (MCL) therapeutic opportunities in the past 10 years. Moreover, an undeniable clinical heterogeneity in treatment response and disease behavior has become apparent in this neoplasm. Thus, the need for biologic markers stratifying patients with MCL in risk classes deserving different treatment approaches has recently been fervently expressed. Among several newly discovered biomarkers, the dismal predictive value of a high proliferative signature has been broadly recognized in large studies of patients with MCL. Different techniques have been used to assess tumor cell proliferation, including mitotic index, immunostaining with Ki-67 antibody, and gene expression profiling. Ki-67 proliferative index, in particular, has been extensively investigated, and its negative impact on relapse incidence and overall survival has been validated in large prospective clinical trials. However, one important pitfall limiting its widespread use in clinical practice is the reported interobserver variability, due to the previous lack of a standardized approach for quantification among different laboratories. In the present review, we describe some of the major techniques to assess cell proliferation in MCL, focusing in particular on the Ki-67 index and its need for a standardized approach to be used in multicenter clinical trials. The value of MCL biologic prognostic scores (as MIPI-b) is discussed, along with our proposal on how to integrate these scores in the planning of future trials investigating a tailored therapeutic approach for patients with MCL. See all articles in this CCR Focus section, "Paradigm Shifts in Lymphoma."
Collapse
Affiliation(s)
- Martin Dreyling
- Medizinische Klinik und Poliklinik III, Klinikum der Universität München, München, Germany.
| | - Simone Ferrero
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino, Italy
| | - Niklas Vogt
- Department of Pathology, Hematopathology Section and Lymph Node Registry Kiel. University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Wolfram Klapper
- Department of Pathology, Hematopathology Section and Lymph Node Registry Kiel. University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | | |
Collapse
|
30
|
Bongiovanni L, D'Andrea A, Porcellato I, Ciccarelli A, Malatesta D, Romanucci M, Della Salda L, Mechelli L, Brachelente C. Canine cutaneous melanocytic tumours: significance of β-catenin and survivin immunohistochemical expression. Vet Dermatol 2015; 26:270-e59. [DOI: 10.1111/vde.12211] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2015] [Indexed: 12/13/2022]
Affiliation(s)
- Laura Bongiovanni
- Faculty of Veterinary Medicine; University of Teramo; Piazza A. Moro 45 Teramo 64100 Italy
| | - Alessandra D'Andrea
- Faculty of Veterinary Medicine; University of Teramo; Piazza A. Moro 45 Teramo 64100 Italy
| | - Ilaria Porcellato
- Department of Veterinary Medicine; University of Perugia; Via San Costanzo 4 Perugia 06126 Italy
| | - Andrea Ciccarelli
- Faculty of Political Science; University of Teramo; Campus Coste Sant'Agostino Teramo 64100 Italy
| | - Daniela Malatesta
- Faculty of Veterinary Medicine; University of Teramo; Piazza A. Moro 45 Teramo 64100 Italy
| | - Mariarita Romanucci
- Faculty of Veterinary Medicine; University of Teramo; Piazza A. Moro 45 Teramo 64100 Italy
| | - Leonardo Della Salda
- Faculty of Veterinary Medicine; University of Teramo; Piazza A. Moro 45 Teramo 64100 Italy
| | - Luca Mechelli
- Department of Veterinary Medicine; University of Perugia; Via San Costanzo 4 Perugia 06126 Italy
| | - Chiara Brachelente
- Department of Veterinary Medicine; University of Perugia; Via San Costanzo 4 Perugia 06126 Italy
| |
Collapse
|
31
|
Shin C, Tallon B. Assessment of tumor mitotic rate in primary cutaneous malignant melanomas 1 mm or less in thickness. J Am Acad Dermatol 2015; 72:405-9. [PMID: 25592624 DOI: 10.1016/j.jaad.2014.09.057] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Revised: 09/22/2014] [Accepted: 09/30/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Tumor mitotic rate in thin melanomas is recognized as a powerful, independent prognostic factor predicting survival. In nonulcerated cases, the presence of any dermal mitotic activity upstages the disease to pT1b. The extent to which tissue should be histologically examined to assess mitogenicity, however, has not been studied. OBJECTIVE We sought to determine whether in staging thin melanomas, there is a significant benefit in examining numerous tissue sections containing invasive disease. METHOD In all, 71 cases of thin cutaneous melanomas diagnosed between January 2012 and June 2013 were identified after a search performed on the Pathlab database. The slides were retrieved and reviewed retrospectively, comparing the identification of the first dermal tumor mitotic figure, if present, at 4 check-points: the first, third, fifth, or tenth tissue section examined. RESULTS A statistically significant difference in identification of the first dermal mitotic figure was found in examining 1 versus 3 tissue sections (P = .0411). No significant difference was found in examining numerous tissue sections. LIMITATIONS This was a retrospective study from a single institution with a limited number of participants. CONCLUSION In staging thin melanomas without ulceration, the optimal number of sections to assess is 3. No additional benefit is gained by examining numerous tissue sections.
Collapse
Affiliation(s)
- Christina Shin
- Dermatopathology Section, Pathlab Bay of Plenty, Tauranga, New Zealand.
| | - Ben Tallon
- Dermatopathology Section, Pathlab Bay of Plenty, Tauranga, New Zealand; DaVinci Clinic, Tauranga, New Zealand
| |
Collapse
|
32
|
Duregon E, Cassenti A, Pittaro A, Ventura L, Senetta R, Rudà R, Cassoni P. Better see to better agree: phosphohistone H3 increases interobserver agreement in mitotic count for meningioma grading and imposes new specific thresholds. Neuro Oncol 2015; 17:663-9. [PMID: 25646026 DOI: 10.1093/neuonc/nov002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 12/30/2014] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Mitotic count on hematoxylin and eosin (H&E)-stained slides is a crucial diagnostic criterion in meningioma grading. However, mitosis assessment on H&E slides can be impaired by technical factors and by pathologist's experience. Phosphohistone H3 (PHH3) serine-10 is a mitosis-specific antibody that has proven to facilitate mitotic count in various tumors. METHODS A series of 70 meningiomas (15 grade I, 40 grade II, 15 grade III) was used to validate PHH3 intra- and interobserver reproducibility and to identify PHH3-specific mitotic thresholds. Four pathologists with different experience in neuropathology counted mitoses on both H&E- and PHH3-stained slides. RESULTS H&E and PHH3 mitotic rates were highly correlated (Pearson's r = 0.92, P < .0001). PHH3 mitotic counts had both a good mean interobserver correlation (R(m) = 0.83) and a good intraclass correlation (0.78), higher than H&E mitotic indices (R(m) = 0.77, intraclass correlation = 0.71). After further stratification of meningiomas according to World Health Organization grade, PHH3 performed better in terms of interobserver concordance (Kendall's W = 0.761) compared with H&E (Kendall's W = 0.697). Referring to the same meningioma groups identified by World Health Organization grade as the gold standard, the volume under the receiver operator characteristic surface was 0.91, indicating a very good diagnostic ability of PHH3 scores in discriminating the 3 meningioma groups. The 2 optimal PHH3-specific cutoff values were 6.61 and 22.02. CONCLUSION PHH3 staining is a useful diagnostic complementary tool to standard H&E mitotic count, optimizing intra- and interobserver reproducibility. PHH3-specific mitotic thresholds should be adopted to avoid overgrading of meningioma when ancillary methods are employed.
Collapse
Affiliation(s)
- Eleonora Duregon
- Department of Medical Sciences, University of Torino, Turin, Italy (A.C., A.P., R.S., P.C.); Department of Oncology, University of Torino at San Luigi Hospital, Orbassano, Italy (E.D.); Department of Statistical Sciences, University of Padua, Padova, Italy (L.V.); Department of Neuro-Oncology, University and City of Health and Science Hospital of Turin, Turin, Italy (R.R.)
| | - Adele Cassenti
- Department of Medical Sciences, University of Torino, Turin, Italy (A.C., A.P., R.S., P.C.); Department of Oncology, University of Torino at San Luigi Hospital, Orbassano, Italy (E.D.); Department of Statistical Sciences, University of Padua, Padova, Italy (L.V.); Department of Neuro-Oncology, University and City of Health and Science Hospital of Turin, Turin, Italy (R.R.)
| | - Alessandra Pittaro
- Department of Medical Sciences, University of Torino, Turin, Italy (A.C., A.P., R.S., P.C.); Department of Oncology, University of Torino at San Luigi Hospital, Orbassano, Italy (E.D.); Department of Statistical Sciences, University of Padua, Padova, Italy (L.V.); Department of Neuro-Oncology, University and City of Health and Science Hospital of Turin, Turin, Italy (R.R.)
| | - Laura Ventura
- Department of Medical Sciences, University of Torino, Turin, Italy (A.C., A.P., R.S., P.C.); Department of Oncology, University of Torino at San Luigi Hospital, Orbassano, Italy (E.D.); Department of Statistical Sciences, University of Padua, Padova, Italy (L.V.); Department of Neuro-Oncology, University and City of Health and Science Hospital of Turin, Turin, Italy (R.R.)
| | - Rebecca Senetta
- Department of Medical Sciences, University of Torino, Turin, Italy (A.C., A.P., R.S., P.C.); Department of Oncology, University of Torino at San Luigi Hospital, Orbassano, Italy (E.D.); Department of Statistical Sciences, University of Padua, Padova, Italy (L.V.); Department of Neuro-Oncology, University and City of Health and Science Hospital of Turin, Turin, Italy (R.R.)
| | - Roberta Rudà
- Department of Medical Sciences, University of Torino, Turin, Italy (A.C., A.P., R.S., P.C.); Department of Oncology, University of Torino at San Luigi Hospital, Orbassano, Italy (E.D.); Department of Statistical Sciences, University of Padua, Padova, Italy (L.V.); Department of Neuro-Oncology, University and City of Health and Science Hospital of Turin, Turin, Italy (R.R.)
| | - Paola Cassoni
- Department of Medical Sciences, University of Torino, Turin, Italy (A.C., A.P., R.S., P.C.); Department of Oncology, University of Torino at San Luigi Hospital, Orbassano, Italy (E.D.); Department of Statistical Sciences, University of Padua, Padova, Italy (L.V.); Department of Neuro-Oncology, University and City of Health and Science Hospital of Turin, Turin, Italy (R.R.)
| |
Collapse
|
33
|
Shin Y, Hyeon J, Lee B, Ha SY, Hong ME, Do IG, Kim KM. PHH3 as an Ancillary Mitotic Marker in Gastrointestinal Stromal Tumors. J Pathol Transl Med 2015; 49:23-9. [PMID: 25812654 PMCID: PMC4357403 DOI: 10.4132/jptm.2014.10.08] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 09/24/2014] [Accepted: 10/08/2014] [Indexed: 12/13/2022] Open
Abstract
Background: Counting mitoses is subjective and time-consuming. The adjunctive diagnostic utility of a recently reported mitotic marker, phosphohistone H3 (PHH3), was investigated in gastrointestinal stromal tumors (GISTs). Methods: We reviewed 77 GISTs for several proliferative indices. These included the mitotic count per 50 high power fields (HPFs), the immunohistochemical Ki- 67 labeling index and the immunohistochemical PHH3 mitotic index (MI). For comparison, Spearman’s rank correlation and interclass correlation coefficient were used. Results: Mitotic counts ranged from 0–138 (mean, 7.57±2.34) and the PHH3 MI ranged from 0–126 per 50 HPFs (mean, 9.61±2.27). We found a positive correlation between mitotic counts and PHH3 MI (r=0.810, p<.001). The inter-observer correlation coefficient for three participants was 0.975 for mitotic counts and 0.940 for the PHH3 MI. When using the PHH3 MI instead of mitotic counts in the Armed Forces Institute of Pathology (AFIP) stratification criteria, 10 cases were reclassified. In one patient with a mitotic count of 2 and a PHH3 MI of 6 per 50 HPFs, distant metastasis occurred. Conclusions: In GISTs, the PHH3 MI correlated adequately with mitotic counts and can be used as a useful adjunctive to count mitotic figures efficiently.
Collapse
Affiliation(s)
- Yooju Shin
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Jiyeon Hyeon
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Boram Lee
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Sang Yun Ha
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Min Eui Hong
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - In Gu Do
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Kyoung-Mee Kim
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea
| |
Collapse
|
34
|
Arps DP, Fullen DR, Chan MP. Atypical umbilical naevi: histopathological analysis of 20 cases. Histopathology 2014; 66:363-9. [DOI: 10.1111/his.12503] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 07/10/2014] [Indexed: 11/28/2022]
Affiliation(s)
- David P Arps
- Department of Pathology; University of Michigan; Ann Arbor MI USA
| | - Douglas R Fullen
- Department of Pathology; University of Michigan; Ann Arbor MI USA
- Department of Pathology Dermatology; University of Michigan; Ann Arbor MI USA
| | - May P Chan
- Department of Pathology; University of Michigan; Ann Arbor MI USA
- Department of Pathology Dermatology; University of Michigan; Ann Arbor MI USA
| |
Collapse
|
35
|
Vogt N, Abramov D, Koch K, Masqué-Soler N, Szczepanowski M, Klapper W. No evidence of cell cycle dysregulation in mantle cell lymphoma in vivo. Leuk Lymphoma 2014; 56:2134-40. [PMID: 25315075 DOI: 10.3109/10428194.2014.975700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Mantle cell lymphoma (MCL) is characterized by the translocation t(11;14)(q13;q32) leading to an overexpression of cyclin D1, a mediator of G1-S phase transition. Thus MCL is regarded as a paradigm of lymphoma with a dysregulated cell cycle. The proliferation rate of MCL is in fact a strong predictor of outcome. We analyzed proteins that are expressed at defined cell cycle phases, such as Ki67, survivin and phosphorylated histone H3 as well as cyclin D1, p53 and p27, on the cellular level by immunofluorescence double stainings in MCL biopsy specimens. Unexpectedly, we did not detect a shortening of early phases in MCL in vivo. Despite the control of the immunoglobulin enhancer, cyclin D1 was expressed in a cell cycle-dependent manner. However, the proliferating Ki67-positive tumor cells expressed low amounts of cyclin D1. Therefore, the expression of cyclin D1 appears not to be the driving factor behind the total proliferation rate of MCL.
Collapse
Affiliation(s)
- Niklas Vogt
- Department of Pathology, Hematopathology Section and Lymph Node Registry, University Hospital Schleswig-Holstein , Campus Kiel, Kiel , Germany
| | | | | | | | | | | |
Collapse
|
36
|
Immunohistochemical expression of hormone receptors in melanoma of pregnant women, nonpregnant women, and men. Am J Dermatopathol 2014; 36:74-9. [PMID: 23812018 DOI: 10.1097/dad.0b013e3182914c64] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The survival advantage of women over men with cutaneous melanoma and the reports of accelerated progression of melanoma during pregnancy have led to studies of the effect of hormones and hormone receptors on the development and progression of melanoma. However, the results are inconclusive. We therefore evaluated the expression of estrogen receptor α, estrogen receptor β, and androgen receptor in melanomas of stage- and age-matched pregnant women, nonpregnant women, and men by immunohistochemical analysis of formalin-fixed, paraffin-embedded archival tissues. In addition, we also assessed the mitotic rate using the antiphosphohistone H3 antibody by immunohistochemistry. Our data showed a trend of more frequent expression of estrogen receptor β in the melanomas of pregnant patients than in the melanomas of male patients, without a significant difference observed between pregnant and nonpregnant women. However, no association between the expression of estrogen receptor β and survival was observed. The small cohort may have limited the statistical power of the study, and large-scale studies are needed to elucidate the potential role of estrogen receptor β as a prognostic marker of melanoma.
Collapse
|
37
|
|
38
|
Comparative diagnostic and prognostic performances of the hematoxylin-eosin and phospho-histone H3 mitotic count and Ki-67 index in adrenocortical carcinoma. Mod Pathol 2014; 27:1246-54. [PMID: 24434900 DOI: 10.1038/modpathol.2013.230] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 10/23/2013] [Indexed: 02/01/2023]
Abstract
Mitotic count on hematoxylin and eosin slides is a fundamental morphological criterion in the diagnosis and grading of adrenocortical carcinoma in any scoring system employed. Moreover, it is the unique term strongly associated with patient's prognosis. Phospho-histone H3 is a mitosis-specific antibody, which was already proven to facilitate mitotic count in melanoma and other tumors. Therefore, a study was designed to assess the diagnostic and prognostic role of phospho-histone H3 in 52 adrenocortical carcinomas, comparing manual and computerized count to standard manual hematoxylin- and eosin-based method and Ki-67 index. Manual hematoxylin and eosin and phospho-histone H3 mitotic counts were highly correlated (r=0.9077, P<0.0001), better than computer-assisted phospho-histone H3 evaluations, and had an excellent inter-observer reproducibility at Bland-Altman analysis. Three of 15 cases having <5 mitotic figures per 50 high-power fields by standard count on hematoxylin and eosin gained the mitotic figure point of Weiss Score after a manual count on phospho-histone H3 slides. Traditional mitotic count confirmed to be a strong predictor of overall survival (P=0.0043), better than phospho-histone H3-based evaluation (P=0.051), but not as strong as the Ki-67 index (P<0.0001). The latter further segregated adrenocortical carcinomas into three prognostic groups, stratifying cases by low (<20%), intermediate (20-50%), and high (>50%) Ki-67 values. We conclude that (a) phospho-histone H3 staining is a useful diagnostic complementary tool to standard hematoxylin and eosin mitotic count, enabling optimal mitotic figure evaluation (including atypical mitotic figures) even in adrenocortical carcinomas with a low mitotic index and with a very high reproducibility; (b) Ki-67 proved to be the best prognostic indicator of overall survival, being superior to the mitotic index, irrespective of the method (standard on hematoxylin and eosin or phospho-histone H3-based) used to count mitotic figures.
Collapse
|
39
|
Alvino E, Passarelli F, Cannavò E, Fortes C, Mastroeni S, Caporali S, Jiricny J, Cappellini GCA, Scoppola A, Marchetti P, Modesti A, D’Atri S. High expression of the mismatch repair protein MSH6 is associated with poor patient survival in melanoma. Am J Clin Pathol 2014; 142:121-32. [PMID: 24926095 DOI: 10.1309/ajcpcx2d9yulbblg] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES The outcome of patients with primary melanoma (PM) cannot be completely explained based on currently adopted clinical-histopathologic criteria. In this study, we evaluated the potential prognostic value of mismatch repair protein expression in PMs. METHODS We examined the immunohistochemical staining of mismatch repair proteins in 18 benign nevi and 101 stage I to III PMs and investigated their association with tumor clinicopathologic variables and melanoma mortality. RESULTS Expression of MSH2, MLH1, and PMS2 was high in benign nevi and reduced in a subset of PMs. Conversely, MSH6 expression was absent or extremely low in benign nevi and increased in a subset of PMs. In the multivariate analysis, including sex, age, Breslow thickness, and ulceration, high MSH6 expression in PMs (ie, immunostaining in >20% of tumor cells) was significantly associated with an increased risk of melanoma mortality (relative risk, 3.76; 95% confidence interval, 1.12-12.70). CONCLUSIONS MSH6 protein expression can be a valuable marker to improve prognosis assessment in PMs.
Collapse
Affiliation(s)
- Ester Alvino
- Institute of Translational Pharmacology, National Council of Research, Rome, Italy
| | | | - Elda Cannavò
- Institute of Molecular Cancer Research, University of Zurich, Zurich, Switzerland
| | - Cristina Fortes
- Epidemiology Unit, Istituto Dermopatico dell’Immacolata-IRCCS, Rome, Italy
| | - Simona Mastroeni
- Epidemiology Unit, Istituto Dermopatico dell’Immacolata-IRCCS, Rome, Italy
| | - Simona Caporali
- Laboratory of Molecular Oncology, Istituto Dermopatico dell’Immacolata-IRCCS, Rome, Italy
| | - Josef Jiricny
- Institute of Molecular Cancer Research, University of Zurich, Zurich, Switzerland
| | | | - Alessandro Scoppola
- Department of Oncology and Dermatological Oncology, Istituto Dermopatico dell’Immacolata-IRCCS, Rome, Italy
| | - Paolo Marchetti
- Department of Oncology, Sant’Andrea Hospital, University of Rome “La Sapienza,” Rome, Italy
| | - Andrea Modesti
- Department of Clinical Sciences and Translational Medicine, University of Rome “Tor Vergata,” Rome, Italy
| | - Stefania D’Atri
- Laboratory of Molecular Oncology, Istituto Dermopatico dell’Immacolata-IRCCS, Rome, Italy
| |
Collapse
|
40
|
Abstract
UNLABELLED Balloon cell nevus is a rare histopathological lesion characterized by a predominance of large, vesicular and clear cells, called balloon cells. There is only 1 case of balloon cell nevus of the iris reported in the literature. CASE REPORT A 55 year-old man presented a pigmented elevated lesion in the right iris since the age of 12 years old. The lesion had been growing for the past 2 years and excision was performed. Histopathological examination showed a balloon cell nevus composed of clear and vacuolated cells without atypia. A typical spindle cell nevus of the iris was also observed. The differential diagnosis included xanthomatous lesions, brown adipocyte or other adipocytic lesions, clear cell hidradenoma, metastatic clear cell carcinoma of the kidney and clear cell sarcoma. The tumor was positive for Melan A, S100 protein and HMB45. CONCLUSION Balloon cell nevus of the iris is rare but should be considered in the differential diagnosis of melanocytic lesions of the iris.
Collapse
|
41
|
Nielsen PS, Spaun E, Riber-Hansen R, Steiniche T. Automated quantification of MART1-verified Ki-67 indices: useful diagnostic aid in melanocytic lesions. Hum Pathol 2014; 45:1153-61. [PMID: 24704158 DOI: 10.1016/j.humpath.2014.01.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 01/02/2014] [Accepted: 01/07/2014] [Indexed: 12/29/2022]
Abstract
The MART1-verified Ki-67 proliferation index is a valuable aid to distinguish melanomas from nevi. Because such indices are quantifiable by image analysis, they may provide a novel automated diagnostic aid. This study aimed to validate the diagnostic performance of automated dermal Ki-67 indices and to explore the diagnostic capability of epidermal Ki-67 in lesions both with and without a dermal component. In addition, we investigated the automated indices' ability to predict sentinel lymph node (SLN) status. Paraffin-embedded tissues from 84 primary cutaneous melanomas (35 with SLN biopsy), 22 melanoma in situ, and 270 nevi were included consecutively. Whole slide images were captured from Ki-67/MART1 double stains, and image analysis computed Ki-67 indices for epidermis and dermis. In lesions with a dermal component, the area under the receiver operating characteristic (ROC) curve was 0.79 (95% confidence interval [CI], 0.72-0.86) for dermal indices. By excluding lesions with few melanocytic cells, this area increased to 0.93 (95% CI, 0.88-0.98). A simultaneous analysis of epidermis and dermis yielded an ROC area of 0.94 (95% CI, 0.91-0.96) for lesions with a dermal component and 0.98 (95% CI, 0.97-1.0) for lesions with a considerable dermal component. For all lesions, the ROC area of the simultaneous analysis was 0.89 (95% CI, 0.85-0.92). SLN-positive patients generally had a higher index than SLN-negative patients (P ≤ .003). Conclusively, an automated diagnostic aid seems feasible in melanocytic pathology. The dermal Ki-67 index was inferior to a combined epidermal and dermal index in diagnosis but valuable for predicting the SLN status of our melanoma patients.
Collapse
Affiliation(s)
- Patricia Switten Nielsen
- Department of Pathology, Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark.
| | - Eva Spaun
- Department of Pathology, Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark
| | - Rikke Riber-Hansen
- Department of Pathology, Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark
| | - Torben Steiniche
- Department of Pathology, Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark
| |
Collapse
|
42
|
Current breast cancer proliferative markers correlate variably based on decoupled duration of cell cycle phases. Sci Rep 2014; 4:5122. [PMID: 24874299 PMCID: PMC4038821 DOI: 10.1038/srep05122] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 05/12/2014] [Indexed: 12/23/2022] Open
Abstract
Mitotic count, PhH3, and MIB-1 are used as measures of the proportion of proliferating malignant cells in surgical pathology. They highlight different stages of the cell cycle, but little is known about how this affects their counts. This study assesses the strength of their correlations and attempts to determine the relationship between them. Proliferation counts for forty-nine consecutive cases of invasive breast carcinomas were analyzed, with the same tumor area on each stain counted using digital image analysis. The integrated optical density (IOD) of nuclei was measured as an approximation of nuclear DNA content. PhH3 strongly correlated with mitotic count (r = 0.94). Weaker correlations were found between MIB-1 versus PhH3 (r = 0.79) and mitotic count (r = 0.83). Nuclear IOD showed stronger correlation with MIB-1 (r = 0.37) than to mitotic count (r = 0.23) and PhH3 (r = 0.34). With evidence from a literature review, it is suggested that the weaker correlations with MIB-1 are not explained by count imprecision or error, but relies on temporal decorrelation between cell cycle phases. Consequences on correlation between these proliferative markers are illustrated by mathematical models.
Collapse
|
43
|
Reed D, Kudchadkar R, Zager JS, Sondak VK, Messina JL. Controversies in the evaluation and management of atypical melanocytic proliferations in children, adolescents, and young adults. J Natl Compr Canc Netw 2014; 11:679-86. [PMID: 23744867 DOI: 10.6004/jnccn.2013.0087] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The rising incidence of melanoma in children has brought increased attention to the clinical and pathologic diagnosis of pigmented lesions in the pediatric age group. Although melanoma in infancy and early childhood is often associated with large congenital nevi, in older children and teenagers it is most often sporadic, occurring in patients with a low skin phototype and substantial sun exposure. The rarity of this potentially fatal disorder demands astute clinical attention and a high index of suspicion for atypical lesions in pediatric patients. The challenges include the difficult decision of whether to biopsy and an often equivocal pathologic diagnosis. These diagnostically challenging and equivocal lesions lead to a degree of uncertainty regarding additional workup, prognosis, potential therapy, and follow-up plans. Consultation with a specialty dermatopathologist can be very helpful, and advanced molecular diagnostic techniques may be used in selected circumstances. Although still controversial, good evidence exists to justify a role for sentinel lymph node biopsy. Patients with atypical melanocytic proliferations have a high rate of positive sentinel lymph nodes; however, their outcomes are clearly better than in similarly staged adults with conventional melanoma. With the multiple variables involved and the relative lack of prospectively derived evidence, clinical decision-making is challenging and patients and families may experience considerable stress. This article provides data and weighs the pros and cons of a rationale for decision-making in pediatric and young adult patients with diagnostically challenging melanocytic lesions.
Collapse
Affiliation(s)
- Damon Reed
- Department of a Sarcoma Oncology, Moffitt Cancer Center, Tampa, Florida 33612, USA.
| | | | | | | | | |
Collapse
|
44
|
Mir R, Stanzani E, Martinez-Soler F, Villanueva A, Vidal A, Condom E, Ponce J, Gil J, Tortosa A, Giménez-Bonafé P. YM155 sensitizes ovarian cancer cells to cisplatin inducing apoptosis and tumor regression. Gynecol Oncol 2013; 132:211-20. [PMID: 24262875 DOI: 10.1016/j.ygyno.2013.11.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 11/05/2013] [Accepted: 11/11/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The objective of this study is to chemosensitize ovarian cancer (OVCa) cells to cisplatin (CDDP) using an inhibitor of Survivin, YM155. The efficacy of YM155 in combination with CDDP was determined in vitro, ex vivo and in vivo. METHODS Human OVCa cell lines A2780p and their cisplatin-resistant derivative A2780cis, were treated with CDDP, YM155, and the combined treatment (YM155+CDDP), and cell viability, mRNA and protein expression levels, cell-cycle distribution, and DNA damage were then evaluated. Furthermore, the efficacy of YM155 combined with CDDP was further examined in established primary cell cultures and xenograft models. RESULTS The combination of YM155 with CDDP induced G2/M cell cycle arrest and apoptosis, increased DNA damage, and decreased Survivin levels, especially in A2780cis CDDP-resistant cells. Additionally, YM155 in combination with CDDP sensitized primary cell cultures to CDDP. Studies in vivo showed how this combination significantly decreased the tumor size of OVCa xenografts. CONCLUSIONS Our results demonstrate that in OVCa cells the expression of Survivin did not affect their sensitivity to YM155, suggesting that Survivin was not the only target of YM155. The combination of YM155 with CDDP could be a good option for therapy of CDDP-resistant OVCa, independently of p53 status.
Collapse
Affiliation(s)
- Roser Mir
- Departament de Ciències Fisiològiques II, Faculty of Medicine, Campus of Health Sciences of Bellvitge, Universitat de Barcelona, IDIBELL, Spain
| | - Elisabetta Stanzani
- Departament de Ciències Fisiològiques II, Faculty of Medicine, Campus of Health Sciences of Bellvitge, Universitat de Barcelona, IDIBELL, Spain
| | - Fina Martinez-Soler
- Departament de Ciències Fisiològiques II, Faculty of Medicine, Campus of Health Sciences of Bellvitge, Universitat de Barcelona, IDIBELL, Spain; Department of Basic Nursing, School of Nursing of the Health Campus of Bellvitge, Universitat de Barcelona, IDIBELL, Spain
| | - Alberto Villanueva
- Translational Research Laboratory, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute, IDIBELL, Spain
| | - August Vidal
- Department of Pathology, Hospital de Bellvitge, Department of Pathology and Experimental Therapeutics, Universitat de Barcelona, IDIBELL, Spain
| | - Enric Condom
- Department of Pathology, Hospital de Bellvitge, Department of Pathology and Experimental Therapeutics, Universitat de Barcelona, IDIBELL, Spain
| | - Jordi Ponce
- Department of Gynecology, Hospital de Bellvitge, Barcelona, Spain
| | - Joan Gil
- Departament de Ciències Fisiològiques II, Faculty of Medicine, Campus of Health Sciences of Bellvitge, Universitat de Barcelona, IDIBELL, Spain
| | - Avelina Tortosa
- Department of Basic Nursing, School of Nursing of the Health Campus of Bellvitge, Universitat de Barcelona, IDIBELL, Spain.
| | - Pepita Giménez-Bonafé
- Departament de Ciències Fisiològiques II, Faculty of Medicine, Campus of Health Sciences of Bellvitge, Universitat de Barcelona, IDIBELL, Spain.
| |
Collapse
|
45
|
Nogueira-Ferreira R, Vitorino R, Ferreira-Pinto MJ, Ferreira R, Henriques-Coelho T. Exploring the role of post-translational modifications on protein-protein interactions with survivin. Arch Biochem Biophys 2013; 538:64-70. [PMID: 23938875 DOI: 10.1016/j.abb.2013.07.027] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 07/17/2013] [Accepted: 07/25/2013] [Indexed: 12/31/2022]
Abstract
Survivin is a member of the inhibitor of apoptosis protein (IAP) family with crucial roles in apoptosis and cell cycle regulation. Post-translational modifications (PTMs) have a ubiquitous role in the regulation of a diverse range of proteins' cellular functions and survivin is not an exception. Phosphorylation, acetylation and ubiquitination seem to regulate survivin anti-apoptotic and mitotic roles and also its nuclear localization. In the present review we explore the role of PTMs on protein-protein interactions focused on survivin to provide new insights into the functions and cell localization of this IAP in pathophysiological conditions, which might help the envisioning of novel targeted therapies for diseases characterized by impaired survivin activity. Protein-protein interaction analysis was performed with bioinformatics tools based on published data aiming to give an integrated perspective of this IAP's role in the cell.
Collapse
Affiliation(s)
- Rita Nogueira-Ferreira
- QOPNA, Department of Chemistry, University of Aveiro, Aveiro, Portugal; Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto, Porto, Portugal
| | | | | | | | | |
Collapse
|
46
|
Nowak M, Svensson MA, Carlsson J, Vogel W, Kebschull M, Wernert N, Kristiansen G, Andrén O, Braun M, Perner S. Prognostic significance of phospho-histone H3 in prostate carcinoma. World J Urol 2013; 32:703-7. [PMID: 23887713 DOI: 10.1007/s00345-013-1135-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 07/17/2013] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Prostate cancer is the second most common cancer in men and the sixth most common cause of death from cancer in men worldwide. Currently, a sufficient pathological distinction between patients requiring further treatment and those for which active surveillance remains an option is still lacking, which leads to the problem of overtreatment. Cell proliferation is routinely assessed by detecting Ki-67 antigen. While Ki-67 is expressed throughout the interphase of proliferating cells, phosphorylation of the chromatin constituent histone H3 occurs only during the late G2 phase and mitosis thus providing a more strict assessment of the mitotic activity. We undertook this study to test whether expression of the recently introduced proliferation marker phospho-histone H3 (pHH3) in prostate carcinoma tissue sections exhibits prognostic significance in comparison with Ki-67. METHODS Protein expression of pHH3 and Ki-67 was assessed on TMA consisting of paraffin-embedded tissue from men that had undergone radical prostatectomy. The analysis included triplicate tissue cores of a total of 339 tumor foci. Immunohistochemical staining of pHH3 and Ki-67 was performed and analyzed using Definiens imaging software. RESULTS Prostate cancer tissue exhibited a significantly higher frequency of pHH3-positive cells compared to benign prostate tissue. pHH3 expression was significantly correlated with Ki-67 expression. Furthermore, statistical analysis revealed positive correlation between pHH3 expression and PSA levels at diagnosis and in addition negatively correlated with overall survival. In contrast to Ki-67 staining, pHH3 expression did not correlate with Gleason grade. CONCLUSION Our data point to a conceivable role of pHH3 as prognostic biomarker in prostate carcinoma.
Collapse
Affiliation(s)
- Michael Nowak
- Institute of Pathology, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany
| | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Mitotic rate in melanoma: prognostic value of immunostaining and computer-assisted image analysis. Am J Surg Pathol 2013; 37:882-9. [PMID: 23629443 DOI: 10.1097/pas.0b013e31827e50fa] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The prognostic value of mitotic rate in melanoma is increasingly recognized, particularly in thin melanoma in which the presence or absence of a single mitosis/mm can change staging from T1a to T1b. Still, accurate mitotic rate calculation (mitoses/mm) on hematoxylin and eosin (H&E)-stained sections can be challenging. Antimonoclonal mitotic protein-2 (MPM-2) and antiphosphohistone-H3 (PHH3) are 2 antibodies reported to be more mitosis-specific than other markers of proliferation such as Ki-67. We used light microscopy and computer-assisted image analysis software to quantify MPM-2 and PHH3 staining in melanoma. We then compared mitotic rates by each method with conventional H&E-based mitotic rate for correlation with clinical outcomes. Our study included primary tissues from 190 nonconsecutive cutaneous melanoma patients who were prospectively enrolled at New York University Langone Medical Center with information on age, gender, and primary tumor characteristics. The mitotic rate was quantified manually by light microscopy of corresponding H&E-stained, MPM-2-stained, and PHH3-stained sections. Computer-assisted image analysis was then used to quantify immunolabeled mitoses on the previously examined PHH3 and MPM-2 slides. We then analyzed the association between mitotic rate and both progression-free and melanoma-specific survival. Univariate analysis of PHH3 found significant correlation between increased PHH3 mitotic rate and decreased progression-free survival (P=0.04). Computer-assisted image analysis enhanced the correlation of PHH3 mitotic rate with progression-free survival (P=0.02). Regardless of the detection method, neither MPM-2 nor PHH3 offered significant advantage over conventional H&E determination of mitotic rate.
Collapse
|
48
|
Held L, Eigentler TK, Metzler G, Leiter U, Messina JL, Glass LF, Garbe C, Bauer J. Proliferative activity, chromosomal aberrations, and tumor-specific mutations in the differential diagnosis between blue nevi and melanoma. THE AMERICAN JOURNAL OF PATHOLOGY 2012; 182:640-5. [PMID: 23261261 DOI: 10.1016/j.ajpath.2012.11.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Revised: 10/26/2012] [Accepted: 11/08/2012] [Indexed: 10/27/2022]
Abstract
Blue nevi are a clinically and pathologically heterogeneous group of benign pigmented dermal melanocytic tumors that may exhibit histologic overlap with malignant melanoma. This study evaluates the role of immunohistochemical and molecular analyses in the classification and differential diagnosis between blue nevi and melanoma. Twenty-three dermal melanocytic tumors, initially diagnosed as benign or ambiguous, were subjected to immunohistochemical staining for phosphohistone H3 and MIB-1 to evaluate mitotic activity, comparative genomic hybridization to detect chromosomal aberrations, and GNAQ, GNA11, BRAF, NRAS, and KRAS sequencing. Of 19 patients with follow-up information (median, 1.6 years), 3 developed recurrent or metastatic disease. Nevertheless, 11 of the 19 patients with follow-up had <2 years of follow-up. Nine of 23 patients showed chromosomal aberrations, including all 3 patients with tumor recurrence or progression. There was no significant correlation between mutation status (P = 0.6) or mitotic rate (P = 0.3) and outcome. In conclusion, three of nine patients with chromosomal aberrations developed tumor recurrence or progression. Patients with histologically ambiguous dermal melanocytic proliferations that exhibit copy number aberrations should undergo careful clinical follow-up.
Collapse
Affiliation(s)
- Laura Held
- Center for Dermatooncology, Department of Dermatology, University Hospital Tuebingen, Tuebingen, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
49
|
Kim A, Im DH, Kim K, Kim JY, Sol MY, Lee JH, Choi KU. Usefulness of anti-phosphohistone H3 immunoreactivity to determine mitotic rate in gastrointestinal stromal tumors. ACTA ACUST UNITED AC 2012. [DOI: 10.1111/baap.12003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Ahrong Kim
- Department of Pathology; Pusan National University Hospital; Pusan National University School of Medicine; Busan
| | - Dong Han Im
- Department of Medicine, The Graduate School of Medicine; Pusan National University
| | - Kyungbin Kim
- Department of Pathology; Pusan National University Hospital; Pusan National University School of Medicine; Busan
| | - Jee Yeon Kim
- Department of Pathology; Pusan National University School of Medicine
| | - Mee Young Sol
- Department of Pathology; Pusan National University School of Medicine
| | - Jeong Hee Lee
- Department of Pathology, Pusan National University Yangsan Hospital; Pusan National University School of Medicine; Yangsan; Korea
| | - Kyung Un Choi
- Department of Pathology; Pusan National University School of Medicine
| |
Collapse
|
50
|
|